Provider Demographics
NPI:1750380317
Name:MINHAS, FAROOQ AHMED (MD)
Entity type:Individual
Prefix:
First Name:FAROOQ
Middle Name:AHMED
Last Name:MINHAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1468
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48376-1468
Mailing Address - Country:US
Mailing Address - Phone:248-849-3957
Mailing Address - Fax:248-849-3957
Practice Address - Street 1:16001 W 9 MILE RD
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-3000
Practice Address - Fax:248-849-5392
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI431858310Medicaid
MI0F36024015Medicare ID - Type Unspecified
MIG77261Medicare UPIN